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What is the role of your insurance agent?

Recently a client left my agency because of the "way I handled a claim" for someone she knew. And so that got me to thinking that people don't really understand the role of an agent.

In this situation, I was taken off guard because the person who had the claim had never let me know there was a problem with coverage for the claim even though I had asked them to keep me updated because I wasn't sure if the claim would be covered due to late reporting. And the other reason I was taken off guard is that an an agent or broker I am not involved in the claims process.

The role of your insurance agent is to help you place coverage in the beginning. This means shopping the market for rates and trying to find a carrier that suits you at the best possible rates and coverage. Part of this process is discussing types of coverage to see if various endorsements are something you wish to add. Once we place the initial policy, we process any policy changes you have (new cars, adding on to your house, changing the use of your insured horse, adding staff to your business, etc.) and periodically quote other carriers to see if you are best to stay where you are at or move to a new company. I frequently get calls from clients wanting to know if certain things are covered by a policy which means I have to go re-read policy language with that in mind. Sometimes I have to ask the company how a hypothetical claim or situation might be handled if I find the language isn't crystal clear (because coverage is always going to depend on specific circumstances surrounding that incident).

While we might occasionally report claims on your behalf, we are not at all involved in the claims process. Whether you report your claim directly to the company or if we report it for you, at that point the claim gets handed off to a claims adjustor. We typically do not receive any correspondence about the claim and don't get a status update unless a customer calls us to get help. Even then, our role is strictly limited to finding out what the claims adjustor is doing and maybe explaining that to you in different language - we have no authority to get your claim paid. The claims adjustor is solely responsible for gathering information about your claim and looking at the policy language to see if the language covers the circumstances or not. In many cases you might receive a reservation of rights notice which basically says the insurance company has received your claim but they still reserve the right to deny the claim once they finish gathering the information. If a claim is denied, you will receive a notice that points to the policy language that prevents the claim from being covered. If the claim is paid, the claims adjustor is the one who determines how much is paid (again based on the policy language and any deductible you have).

The role of your agent is best described as being your advocate while at the same time representing any company they write. Your agent will often know whether or not your risk profile meets what a carrier is looking for, or they might know that lately service from a company is not up to par and they won't place you there until that service improves. So if you are having a problem with your insurance, your agent is the one who will help you find the answer or try to explain things differently. Keep the lines of communication with your agent open so they know what is happening on your policy behind the scenes and can help you understand it.


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